HOUSTON — What are the interactive effects of cardiovascular disease (CVD) and chronic kidney disease (CKD) on long-term mortality following major operations?
That was the question addressed in a recent study published in the American Journal of Surgery.1
Researchers from the Michael E. DeBakey VAMC and Baylor College of Medicine, both in Houston, and the VA New York Harbor Healthcare System and the State University of New York Downstate Health Sciences University, both in Brooklyn, NY, performed a national, retrospective cohort study of patients undergoing high-risk operations from 1991 through 2018. Data came from the VA Corporate Data Warehouse and Surgical Quality Improvement Program.
For purposes of the study, preoperative exposures included CVD (history of angina, CHF, MI, stroke, peripheral arterial disease and related procedures) and CKD Stages III-V. Defined as the primary outcome was long-term mortality.
Overall, the study team included 514,057 operations.
After adjustment, the interaction between CVD and CKD Stage III (HR 1.38, 95% CI: 1.35-1.42), Stage IV (HR 1.91, 95% CI: 1.83-2.01) and Stage V (HR 2.70, 95% CI: 2.59-2.81) was found to progressively confer an increasing risk of mortality.
“In the setting of major operations, it is more accurate to interpret CVD and CKD in context of one another while accounting for the degree of baseline renal dysfunction,” the authors pointed out.
- Zamani N, Sharath SE, Kougias P. Combined influence of cardiovascular disease and chronic kidney disease on long-term mortality following major operations. Am J Surg. 2025 Feb 5;242:116239. doi: 10.1016/j.amjsurg.2025.116239. Epub ahead of print. PMID: 39970606.
